Design and development of system integration for fluoroscopic navigation using surgical-guiding robot

Abstract

Fluoroscopic x-ray is an essential tool for orthopedic surgery, especially, Close Intramedullary Nailing Operation. Close intramedullary nailing is a very efficiency technique for treatment the long bone fracture. In this technique, surgeon is required to insert an intramedullary nail into the medullary canal to stabilize the fractured bone. The most difficult task for the surgeon is to identify two screwing holes at the distal location of the nail. In conventional method, surgeon requires a lot of fluoroscopic exposures to recover distal interlocking holes. Therefore, both of surgeon and patient continually absorb an irradiation that is harmful for their long term health. This paper presents a system for fluoroscopic navigation in close intramedullary nailing. The systems are integrated with three sub-systems: 1) A recovery of distal interlocking holes system for locating distal interlocking holes. 2) An optical tracking system for registering an x-ray image coordinate into the world coordinate. 3) A surgical guiding robot system for guiding a position and orientation of distal interlocking holes using robot guidance.